[Follow-up of a case by the hospital-at-home service: a new alternative]. / Seguimiento de un caso clínico en hospitalización a domicilio: una nueva alternativa.

The present article is a continuation of two previously published articles in Enfermería Clínica that describe the clinical course of María, a 26-year-old woman with Down syndrome. The first article described the patient's admission to the intensive care unit (ICU) with a diagnosis of atypical pneumonia. During admission, the patient was completely dependent. The second article described the weaning process when the patient showed anxiety, which was favorably resolved. Maria was discharged to a conventional ward with a nursing discharge report that contained the nursing care performed during her stay in the ICU. The present article describes the patient's follow-up by the hospital-at-home team. The specialized team suggested to María that she continue admission with the possibility of being at home until she could be discharged and followed-up by primary care. The evaluations were performed in 2 phases: a first evaluation before the patient's return to home, in which the suitability of domiciliary care was evaluated, and a second evaluation in which care was planned with María and her family. A hygiene deficit and ineffective management of the family therapeutic regimen were identified. Both problems were approached by the specialized healthcare team within the context of domiciliary care, in which work with the family is essential.

Ansiedad durante el proceso de destete. Estudio de un caso / Anxiety during the weaning process. Study of a case

María es una mujer de 26 años, con síndrome de Down, obesidad mórbida y antecedentes de problemas cardíacos, ingresada en una unidad de cuidados intensivos (UCI) a causa de una neumonía atípica, y en el momento de la valoración estaba sedada y conectada a un ventilador. Este artículo presenta la continuación de un caso clínico publicado con anterioridad en Enfermería Clínica, en el que se describe la evolución clínica y la planificación de los cuidados enfermeros de los nuevos problemas que presentó María durante el proceso de destete del ventilador hasta que fue dada de alta de la UCI. Los diagnósticos enfermeros presentados durante este proceso fueron: ansiedad, que se solucionó a los 3 días de la implementación del plan de cuidados, y suplencia parcial en la necesidad de evitar peligros, causada por la agitación al disminuir la sedación farmacológica. Después de afrontar el proceso de destete satisfactoriamente, se planificaron los cuidados recomendados al alta en la UCI incluidos en el informe de continuidad de cuidados

María is a 26-year-old woman with Down syndrome, morbid obesity and a history of heart abnormalities, was admitted to an intensive care unit due to atypical pneumonia. At evaluation, she was sedated and connected to a ventilator. We present the continuation of a case previously reported in Enfermería Clínica. The clinical course and nursing care planning of new problems presented by María during the process of ventilator weaning until discharge from the intensive care unit (ICU) are described. The nursing diagnoses formulated during this process were: anxiety which was resolved 3 days after implementing a nursing care plan and providing assistance in the need to avoid danger, caused by agitation on reducing sedation. After the patient was satisfactorily weaned from the ventilator, the care recommended on discharge from the ICU included in the continuity of care report was planned